Prevention Of Blood-borne Infections Research Articles

Completion of three-dose hepatitis B vaccination cycle and associated factors among health care workers in the Greater Accra Region of Ghana.

Despite the availability of a safe and effective vaccine coupled with the awareness of the potential risk of Healthcare Workers acquiring Hepatitis B Virus infection, some HCWs never get vaccinated. Generally, hepatitis B vaccination coverage globally is below the expected level as adherence has remained poor in various healthcare settings, especially in developing countries. The objective of this study was to assess the completion of a three-dose Hepatitis B virus vaccination cycle and associated factors among healthcare workers in the Greater Accra Region of Ghana. An analytical cross-sectional study was conducted and included 363 healthcare workers selected using probability sampling procedures. The participants were recruited from five facilities within the Greater Accra Region in the first half of 2018. A pretested questionnaire was used to collect data which was analyzed using SPSS version 21. The proportion of healthcare workers receiving the recommended 3 doses of the hepatitis vaccine was computed. The multivariable analysis procedure identified the factors associated with adherence to the receipt of three doses of the hepatitis B vaccine. Odds ratios were estimated with corresponding confidence intervals with the level of significance set at 0.05. A total of 340 sample units were included in the analysis. Most of the participants (252/340, 74.1%) were females, mainly nurses/midwives (162/340, 47.6%) with a mean age of 34.5 (SD ±7.7). A high proportion of the participants (82.7%) have tertiary/post-tertiary level education and ever participated in at least one training workshop on the prevention of blood-borne infections (80.6%). Overall vaccination uptake was 60.9% (207/340) (95% CI = 55.7%-66.1%). Complete vaccination coverage (three doses) was 46.8% (159/340). High-risk perception (AOR = 4.0; 95% CI = 1.3-12.5), and previous training in infection prevention (AOR = 2.8; 95% CI = 1.1-7.5) were significantly associated with adherence to receipt of three doses of hepatitis B vaccine. Adherence to three-dose hepatitis B vaccination cycles is not universal among the healthcare workers in the Greater Accra Region. Receipt of the three-dose regimen is significantly associated with high-risk perception and attendance of training in infectious disease prevention. Interventions to increase risk perception and training in the prevention of blood-borne infections could improve adherence to complete/full vaccination protocol among healthcare workers who are at constant risk of exposure to the hepatitis B virus.

A Study to Assess the Knowledge Regarding Prevention of Blood Borne Infections among Students of Selected Nursing Institution at Mangaluru

Background of the Study: Blood borne pathogens are microorganisms such as viruses or bacteria that are carried in blood. A blood borne disease that can be spread through contamination by blood and other body fluids. In health care setting, blood born pathogen transmission usually occurs by Percutaneous exposure to the workers mostly happens when they are handling infected patients. 1The aim of our study was to assess the knowledge regarding prevention of blood borne infection among students of selected nursing institution at Mangaluru.
 Materials and Methods: A descriptive study was conducted among104 undergraduate students. Subject was selected using purposive sampling techniques. The information was collected using a demographic Proforma and a self - administered questionnaire. The overall knowledge on prevention of blood born infection was graded as adequate, good, and inadequate.
 Results: The overall knowledge score was majority (64.4%) had average, 33.7% had good and minority (1.9%) had good knowledge regarding blood born infection and its prevention. In this study there was significant (P<0.05) association between knowledge score with age, gender whereas there is no significant association between knowledge score with year of study, previous knowledge on standard precautions and source of information. 
 Conclusion: The present study concludes that the nursing students have a fair knowledge regarding the cause of blood born infections. Competent knowledge is needed to prevent the spread of blood born infections. Successful prevention strategies of blood born infections require a high level of awareness of the infected individual as well as a detailed knowledge among healthcare professionals and society.

Seroprevalence of Hepatitis B virus infection and associated factors among health care workers in Southern Ghana

The World Health Organization estimates that 37% of Hepatitis B Virus (HBV) infections among Health Care Workers (HCWs) are due to percutaneous occupational exposure to blood and body fluids. In Ghana, occupational exposures are rising; however, the burden of HBV infection in HCWs remains unknown. Our study estimated the prevalence of HBV surface antigens and associated factors among HCWs. We conducted a cross-sectional survey of 340 HCWs using a structured pretested questionnaire and screening for HBV surface antigens. Data were analyzed using SPSS version 20.0 with a level of significance set at <0.05. The overall crude prevalence of current HBV infection was 5.9 % (95% CI, 3.0-8.0). Adjusted prevalence by test performance was 5.8%. Prevalence was highest among males 10.2% (95% CI, 4.8-18.5), HCWs other than nurses and doctors 9.2% (95% CI, 4.5-16.2), and those working at lower-level facilities 9.7% (95% CI, 4.8-17.1). Training in the prevention of blood-borne infections was significantly associated with HBV infection (adjusted odds ratio 3.2; 95% CI, 1.1-9.1). HBV infection is high in this population. In addition to lifesaving interventions such as vaccination and the use of immunoglobulin, training in blood-borne infections could prevent new HBV infections among Ghanaian HCWs.

Effectiveness of Structured Teaching Programme on Knowledge Regarding Universal Precautions and the Prevention of Blood Borne Infections among The Final Year B.Sc. Nursing Students of Selected Nursing Colleges

A Quasi experimental approach was used for this study. Objectives are to assess the level of knowledgeregarding universal precautions &amp; the prevention of blood borne infections, effectiveness of structured teachingprogramme, association between the pretest level of knowledge among final year B.Sc.Nursing students withselected demographic variables. The study was carried out Rajeev College of Nursing, Hassan. The samplescomprised of 60 final year B.Sc.Nursing students. Sample was selected by using random sampling techniques. Atotal of 60 final year B.Sc.Nursing students selected for the study by using structured knowledge questionnaire,the selected samples were given pre test questionnaire followed by Structured teaching programme was given toall students for 45 minutes. Post test was conducted by using knowledge questionnaire after 15 days of StructuredTeaching programme for same students. The result of study shows that the post test mean score 20.94 (SD=8.17)was more than the pre test mean score 15.42 (SD=3.35), the obtained mean difference between pre and post testscore is 5.52 (SD=4.82), the obtained ‘t’ value is 13.3. So it is significant at the level of 0.05. It was inferred that finalyear B.Sc.Nursing students knowledge was increased regarding universal precautions and prevention of bloodborne infections after structured teaching programme increase in post test score. Therefore structured teachingprogramme is effective in improving knowledge regarding universal precautions and prevention of blood borneinfections among final years B.Sc.Nursing students, also there was significant in income and occupation ofparents with the level of knowledge and selected demographic variables.

Implementation and first-year operating costs of an academic medical center-based syringe services program

BackgroundSyringe services programs (SSPs) remain highly effective, cost-saving interventions for the prevention of blood-borne infections among people who inject drugs. However, there have been restrictions regarding financial resources allocated to these programs, particularly in the US South. This study aimed to provide cost data regarding the implementation and first-year operations of an academic-based SSP utilizing fixed and mobile strategies, including the integration of onsite wound care.MethodsWe conducted a micro-costing study that retrospectively collected detailed resource utilization and unit cost data for both the fixed and mobile SSP strategies, including onsite wound care, from both healthcare and societal perspectives. A three-step approach was used to identify, measure, and value intervention costs, and cost components were categorized into implementation, variable program, and time-dependent costs. Sensitivity analysis was performed to examine the impact of SSP operational changes (i.e., needs-based distribution and opt-out HIV/HCV testing) on the cost-per-participant. Cost data we presented as overall cost and cost-per-participant adjusted to 2017 US dollars.ResultsA total of 452 and 129 participants enrolled in fixed and mobile SSP services, respectively. The total cost associated with implementation and first year operations for the fixed site was $407,217.22 or $729.72 per participant and $311,625.52 or $2415.70 per participant for the mobile unit. The largest cost component for both modalities was time-dependent costs (personnel and overhead), while intervention materials (syringes, injection equipment, naloxone) were less than 15% of the total program cost.Discussion/conclusionImplementation and operation of new SSP models continue to be low cost compared to treatment for the multitude of harms PWID face without access to evidence-based prevention. Future cost-effectiveness and cost–benefit analyses integrating a comprehensive SSP model within an academic institution, including onsite wound care and other medical services, will provide a more comprehensive understanding of this model, and state-level policy action must be taken to lift the prohibition of state and local funds for the implementation, sustainability, and maintenance of these programs in Florida.

Strengths and Weaknesses in the Risk Management of Blood-Borne Infections: Qualitative Research in Public Health.

This article presents the research from the first phase of our study on blood-borne risk management, wherein we solicited epidemiologists’ and healthcare practitioners’ expert opinions on a blood-borne infection risk assessment in Poland. Forty-two experts were recommended by epidemiology consultants and recruited from all districts in Poland. We used the SWOT (Strengths, Weaknesses, Opportunities, Threats) method in the evaluation. Experts’ opinions showed that there is room for improvement in the prevention of blood-borne infections. Commonly reported weaknesses in the risk assessment included gaps in knowledge and inappropriate procedures, which are largely caused by financial constraints and practitioners’ lack of awareness of developments in their trade. Strengths included legal regulations for medical services and procedures, surveillance, and increasing awareness on the part of medical staff. When paired with the existing statistical data, these results provide a comprehensive view of the problem of blood-borne infections in Poland. The analysis supported the development of a strategy proposal to prevent blood-borne infections and enhance existing risk assessment procedures.

Prevention of blood-borne infections among nurses at Dr. Ivan Seliminski hospital, Sliven

INTRODUCTION : The occupational activities of nurses entail a daily exposure to infectious and non-infec­tious factors that can affect their health. Blood-transmitted pathogens caused by occupational exposure pose the most serious threat. Prevention strategies include vaccinations and universal precaution measures. AIM : The aim of this study is to assess vaccinations and other precautionary measures against blood-borne in­fections: HBV, HCV, HIV, and the attitude towards those among nurses at Dr. Ivan Seliminski Hospital, Sliven. MATERIALS AND METHODS : We used an individual anonymous survey among 55 nurses working in dif­ferent wards of the Hospital. RESULTS AND CONCLUSION : A large number of nurses at the hospital have had an HBV immunisation (69%). A significant proportion have also had serologic status testing for HCV and HIV (58%). Most nurses in­dicated they have had immunisation and testing as a precautionary measure.

Croatian Recommendations for Dialysis of HIV-Positive Patients

Abstract Human immunodeficiency virus (HIV) infection may be associated with renal impairment since about 0.4% of all HIV-positive patients develop end-stage renal disease. The share of patients with HIV infection in hemodialysis centers throughout the world ranges from 0.3% to as high as 38%. In Croatia, renal replacement therapy was needed by 1% of all the HIV-positive patients from 1985 until the end of 2014. Healthcare professionals (HP) should be aware of the risks of occupational exposure to blood-borne infections in their daily work. Performing dialysis in HIV-positive patients increases the risk of exposure to HIV during the extracorporeal circulation of the infected blood. However, post-exposure prophylaxis (PEP) with effective antiretroviral drugs significantly reduces the risk of infection after occupational exposure. On behalf of the Croatian Society of Nephrology, Dialysis and Transplantation, the authors of this paper have proposed recommendations for the management of HIVpositive patients on dialysis, which aim to prevent the transmission of HIV among patients and HPs. The important recommendations include the following: 1. when the need arises, it is necessary to provide HIV-positive patients with dialysis in the vicinity of their place of residence. 2. HIV-positive patients should be dialyzed with a separate hemodialysis machine in an isolated area. Alternatively, they can be dialyzed in an area for the hemodialysis of HCV-positive and/or HBVpositive patients. 3. Specialized and trained personnel should be provided during the hemodialysis procedure, together with strict compliance with the standard precautions for the prevention of blood-borne infections. 4. There should be a good and prompt cooperation with the National Referral Center for HIV infection.

8-176 - Knowledge and Obstacles in Prevention of Bloodborne Infections among First Responders in Northern Thailand

8-176 - Knowledge and Obstacles in Prevention of Bloodborne Infections among First Responders in Northern Thailand

Effect of Education Intervention on Prevention of Bloodborne Infections for Health Care Workers in Family Medicine Centers , Suez Canal University in Ismailia City , Egypt

Introduction: Healthcare workers (HCWs) are at particular risk for occupational exposure to bloodborne pathogens, including hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). Objective: to assess the effect of education intervention on knowledge, attitude and practice of (compliance with) preventive measures of bloodborne infections (BBIs) by health care workers. Methods: The study was a pre-post quasi- experimental intervention. It was conducted between June and October 2015 in 3 family medicine centers with affliation to Suez Canal University in Ismailia city. Sample was convenient; it included all 82 healthcare workers (family physicians, laboratory technicians, nurses and janitors). Knowledge and attitude were evaluated by a questionnaire. Practice was assessed by observation. Educational training intervention was designed and conducted by the researchers about the common BBIs and standard precautions (SPs) based on guidelines. Results: Statistically significant difference was found between pre and post intervention in means of knowledge, attitude, practice and overall KAP scores of all HCWs (P < 0.001) with large effect size Cohen's d more than .8. The highest median scores of all SPs in pre intervention were for no needle recapping (Mdn=100) with significant difference between pre and post intervention (P <0.001). Conclusions: Continuous periodic education on standard precautions is recommended to cover areas for improvements in knowledge such as alcohol rubbing, that is not the required action on exposure to body fluids and the recommended time of hand washing (40-60 seconds); attitude towards revising guidelines and ensuring availability of infection control supplies; and ensure compliance with hand hygiene, sharps handling, decontamination of spills and wearing gowns.

Risk of hepatitis B and C infections in Tehranian wrestlers.

Although bloodborne infections are among the most important global health issues, limited data are available on bloodborne infections in athletes. To determine and compare the prevalence of markers of hepatitis B (HBV) and hepatitis C (HCV) viruses and the risk factors for these infections among wrestlers in Tehran and among a control group of athletes in the same geographic area who took part in low- to moderate-contact sports (ie, volleyball and soccer). Case-control study. Laboratory. A total of 420 male wrestlers were randomly selected from 28 wrestling clubs in Tehran using a cluster-sample-setting method. The control group (205 volleyball players from 21 clubs and 205 soccer players from 16 clubs) was selected from the same geographic area. The risk factors for HBV and HCV and serum levels of anti-HBcAg (antibodies to the HBV core antigen), HBsAg (HBV surface antigen), and anti-HCV (antibodies to HCV) in both groups. The prevalence of anti-HBcAg was 13.4% (95% confidence interval [CI] = 10.2%, 16.7%) in wrestlers and 10.9% (95% CI = 7.9%, 14.0%) in the control group. The prevalence of HBsAg was 1.2% (95% CI = 0.2%, 2.2%) in wrestlers and 0.5% (95% CI = -0.2%, 1.2%) in the control group. The prevalence of anti-HCV was 0.5% (95% CI = -0.2%, 1.1%) in wrestlers and 0 in the control group. Some risk factors for bloodborne infections were more common in the wrestlers than in the control group. Within the limits of our study, we found no evidence that participation in Tehranian wrestling increased HBV or HCV transmission when compared with transmission in athletes participating in low- to moderate-contact sports. Prevention of bloodborne infections in Tehranian wrestlers should be focused not only on appropriate care for bleeding injuries but also on general risk factors for these conditions.

Knowledge, attitudes and practices towards blood-borne pathogens in healthcare workers in Banja Luka, Bosnia and Herzegovina

Abstract Exposure to blood borne pathogens poses a serious risk to healthcare workers (HCWs). This study was undertaken to investigate knowledge, attitudes and practices among HCWs towards blood borne pathogens. We carried out a cross sectional KAP (Knowledge, Attitudes and Practice) study, using self-administered questionnaire. The study population consisted of 127(23.6%) physicians, and 410 (76.4%) nurses and laboratory technicians. Factor analysis and conditional multiple logistic regression were used in statistical analysis. We found that the knowledge of the epidemiological characteristics of blood-borne infection, the risk of acquisition and available preventative measures among HCWs is insufficient. Doctors were more knowledgeable about the transmissibility of blood borne pathogens regarding sexual transmission after percutaneous exposure (odds ratio) OR=2.71; 95% (confidence interval) CI=1.51–4.84, OR=2.45; 95% CI=1.21–4.96), respectively. Nurses reported professional exposure to patient’s blood more often than doctors (OR=0.90; 95% CI=0.84–0.96). Negative attitudes towards HIV positive patients were also noted. Less than half of HCWs used appropriate barriers (gloves, mask, and glasses) to protect them regularly. The compulsory preventive measures implied by the results of this study are continuous education, immunization against Hepatitis B, implementing Standard Precautions, as well as the development of written guidelines on the prevention of blood-borne infections.

Syringe access for the prevention of blood borne infections among injection drug users.

BackgroundApproximately one-third of acquired immunodeficiency syndrome cases in the United States are associated with the practice of sharing of injection equipment and are preventable through the once-only use of syringes, needles and other injection equipment.DiscussionSterile syringes may be obtained legally by 4 methods depending on the state. They may be purchased over the counter, prescribed, obtained at syringe exchange programs or furnished by authorized agencies. Each of these avenues has advantages and disadvantages; therefore, legal access through all means is the most likely way to promote the use of sterile syringes.SummaryBy assisting illicit drug injectors to obtain sterile syringes the primary care provider is able to reduce the incidence of blood borne infections, and educate patients about safe syringe disposal. The provider is also able to initiate discussion about drug use in a nonjudgmental manner and to offer care to patients who are not yet ready to consider drug treatment.

Prophylaxis of Hepatitis C with Intramuscular Immunoglobulin

Hepatitis C virus (HCV) affects millions of individuals worldwide. In most cases, HCV infection progresses to chronic liver disease and, subsequently, to liver cirrhosis and hepatocellular carcinoma. HCV is transmitted by the parenteral route, for example by transfusion of blood or blood products, injection during drug abuse, etc., and by the inapparent parenteral route (penetration of the virus through difficult-to-identify microlesions present on the skin or mucosae), for example, sexual exposure or household exposure to infected contacts, etc. The cost of chronic hepatitis C and its sequelae is high in both financial and human terms. At present, only anti-HCV screening of blood/organ/tissue donors and universal precautions for the prevention of blood-borne infections are recommended for HCV prevention. Before the discovery of the main aetiological agent of non-A, non-B hepatitis (HCV), several randomised controlled clinical trials demonstrated that standard intramuscular immunoglobulin exerted a preventive effect on post-transfusional and sexual and /or horizontal transmission of non-A, non-B hepatitis. When serological tests for HCV infection became available, bimonthly inoculation of standard unscreened intramuscular immunoglobulin (prepared from plasma pools containing about 2% of anti-HCV-positive units) was demonstrated to significantly prevent sexually transmitted HCV infection. The immunoglobulin used contained high titres of anti-HCV neutralising antibodies (anti-E2 neutralisation of binding assay), whereas currently available commercial screened immunoglobulin (prepared from anti-HCV-negative blood units) did not. This finding suggested that anti-HCV neutralising antibodies are concentrated only in anti-HCV-positive units (which are currently discarded). Thus, anti-HCV hyperimmune globulin (HCIg) can be produced only from anti-HCV-positive units. The neutralising titre can be increased by the exclusive use of units with higher titres of neutralising antibodies. Unlike other hyperimmune globulins, which are produced from a limited number of selected donors, HCIg should be produced from a large number of units so as to contain neutralising antibodies to the different HCV strains. HCIg will have a number of advantages: (i) it is easy to produce and inexpensive; (ii) it has a long half-life, allowing infrequent administration; (iii) new additional viral inactivation procedures have been introduced to eradicate transmission of infection, and (iv) it may be possible to neutralise all the emerging HCV strains. HCIg could be used in all individuals at risk of HCV infection (sexual partners, haemodialysis patients, etc), in preventing reinfection of transplanted livers, and perhaps also in the treatment of chronic hepatitis C, alone or associated with other drugs.

Prevention of HIV/AIDS and Other Blood-Borne Diseases Among Injection Drug Users

We report the results of a survey of laws and regulations governing the sale and possession of needles and syringes in the United States and its territories and discuss legal and public health proposals to increase the availability of sterile syringes, as a human immunodeficiency virus (HIV) transmission prevention measure, for persons who continue to inject drugs. Every state, the District of Columbia (DC), and the Virgin Islands (VI) have enacted state or local laws or regulations that restrict the sale, distribution, or possession of syringes. Drug paraphernalia laws prohibiting the sale, distribution, and/or possession of syringes known to be used to introduce illicit drugs into the body exist in 47 states, DC, and VI. Syringe prescription laws prohibiting the sale, distribution, and possession of syringes without a valid medical prescription exist in 8 states and VI. Pharmacy regulations or practice guidelines restrict access to syringes in 23 states. We discuss the following legal and public health approaches to improve the availability of sterile syringes to prevent bloodborne disease among injection drug users: (1) clarify the legitimate medical purpose of sterile syringes for the prevention of HIV and other blood-borne infections; (2) modify drug paraphernalia laws to exclude syringes; (3) repeal syringe prescription laws; (4) repeal pharmacy regulations and practice guidelines restricting the sale of sterile syringes; (5) promote professional training of pharmacists, other health professionals, and law enforcement officers about the prevention of blood-borne infections; (6) permit local discretion in establishing syringe exchange programs; and (7) design community programs for safe syringe disposal.